This article examines the increasing importance of human service corporations within the American welfare state. In particular, the article investigates the historical and philosophical background of the corporatisation of welfare, the expanding social welfare market, and the scope of human service corporations. The consequence of corporatisation, including standardisation, commodification, and the oligarchic nature of human services are also examined. Lastly, the authors explore the implications of corporatisation for the future of the US welfare state.

This paper discusses the various ways in which British Afro Caribbeans are disadvantaged in their encounter with psychiatry. It suggests that far from being monolithic and institutional, racism must be deconstructed and traced to the actions, practices and procedure involved in specific encounters. The procedures of psychiatry are examined through the discourses of psychiatry and psychiatric epidemiology. From this analysis it is suggested that psychiatry's relationship to Afro Caribbean populations in Britain arises from the ways in which psychiatry conceptualises notions of ethnicity, race and cultural difference, as well as ways in which it organises and reproduces itself as a form of therapeutic intervention.

This article explores the role of political agents, institutions, circumstances, and ideas in the development of public health policies in Britain. The first part attempts to define public health. The second section of the article looks at the experience of the Victorian public health movement. The final part considers the re-emergence of the public health perspective. The underlying theme of the article is that an awareness of the political dimension, both contemporary and historical, improves our understanding of developments in the field of public health. The main conclusions reached are: first, that given the formidable political obstacles which exist, public health reform will only succeed if the reformers themselves operate with full awareness of the political dimension; second, that the modern public health debate is unlikely to be resolved in the short term.

This paper presents qualitative evidence about managers' perceptions of retrenchment in the National Health Service in England. It outlines the financial situation of six case-study district health authorities during the expenditure crisis of 1987/8, and presents the results of an interview survey of district general managers and directors of finance about the implementation of cutbacks. Similar policies of cost-containment and service reduction are mirrored by similarity in the views held by managers and treasurers. Key concerns included the need for a reconstruction of local priorities in service provision, and the advocacy of an extension of managerial control over hospital consultants. These issues are discussed briefly in the context of the recent government proposals to introduce market mechanisms into the NHS, and wider arguments about medical dominance and bureaucratic/professional conflicts.

The study reported on in this paper used existing data to create a broad measure of living standards as advocated by Townsend (1979) in developing his concept of relative deprivation. Linked data from the General Household Survey and the Family Expenditure Survey was used to compare the living standards of households at different income levels. A particular focus of the study was the living standards of households on supplementary benefit (as it was at the time of the surveys). Analyses showed that in general they score less well on individual indicators of living standards than other households of the same type on low incomes. A summary index was developed which indicated the similarity of standards of living for households on supplementary benefit (SB) irrespective of household type. The specific indices constructed for each of the family types investigated suggested that families on SB with children have a relatively lower standard of living than other families with children whereas elderly households on supplementary benefit are not so deprived in comparison with other elderly households.